S9.1 GI Infections Flashcards

1
Q

What are some defences of the GI tract?

A

Saliva
Gastric acid
Bile
Colonic mucus

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2
Q

What is the benefit of lots of bacteria residing in the colon?

A

This prevents harmful bacteria competing for nutrients

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3
Q

What is the function of the gut microbiome (bacteria in the colon)?

A

The microbiome produces antimicrobial substances (SCFAs), and helps develop the newborn immune system

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4
Q

What are the 3 SCFAs produced by the gut microbiome?

A

Butyrate - energy source for colonocytes
Acetate - involved in cholesterol metabolism
Propionate - helps regulate satiety

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5
Q

What foods are good and bad for the microbiome?

A

High fibre diet is good

Sweeteners are bad

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6
Q

What is faecal microbiota use to treat?

A

Diarrhoea

Comes from donors

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7
Q

What are the main bacteria which cause diarrhoea/gastroenteritis?

A

Salmonella, Campylobacter, Shigella, E. coli, Clostridium difficile

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8
Q

What are the main virus’ which cause diarrhoea/gastroenteritis?

A

Norovirus, Rotavirus, Adenoviruses

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9
Q

Wha are the main parasites which cause diarrhoea/gastroenteritis?

A

Cryptosporidium, Giardia, Entamoeba

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10
Q

What is the transmission and symptoms of salmonella?

A

Ingesting contaminated food/water

Vomiting and diarrhoea

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11
Q

Outline the pathophysiology of salmonella

A

Enter enterocytes by endocytosis, move to submucosa where they’re taken up my macrophages
Macrophages transfer salmonella to reticuloendothelial system where they multiply causing lymphoid hyperplasia
Salmonella then re-enters gut from the liver

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12
Q

What is the transmission and symptoms of campylobacter infection?

A

Faecal-oral, contained food/water

Abdominal cramps, diarrhoea (can be bloody)

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13
Q

What are the complications of campylobacter?

A

Acute – cholecystitis

Late - Guillain-Barré syndrome

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14
Q

What is the treatment for campylobacter?

A

Fluids/electrolytes

Antibiotics for severe disease (eg bloody diarrhoea)

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15
Q

What is the transmission and virulence factor for Shigella?

A

Faecal-oral, contaminated food/water

Enterotoxins

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16
Q

Outline the pathophysiology of shigella

A

Shigella enters intestinal epithelia by endocytosis and multiplies.
Then invades neighbouring cells.
As cells die, mucosal abscesses form causing BLOODY diarrhoea

17
Q

What is the transmission of enterotoxigenic E. coli?

A

Faecal-oral, contaminated water

Most common cause of travellers diarrhoea

18
Q

Outline the pathophysiology of E. coli

A

Invades enterocytes and produce enterotoxins which cause hypersecretion of Cl-, so water leaves cells into gut lumen

19
Q

What is the method of transmission of C. Diff?

A

Faecal-oral

20
Q

Outline the pathophysiology of C. Diff

A

Spore formation

Following antibiotics, C diff can release; toxin A (enterotoxin causing excessive secretion) or toxin B (cytotoxin)

21
Q

Pseudomembranous colitis is a complication of C. Diff, what is it?

A

Elevated yellow plaques join to form a pseudomembrane

22
Q

What is the treatment for C. Diff?

A

Metronidazole

Vancomycin (severe)

23
Q

What is the transmission and symptoms of rotavirus?

A

Faecal-oral

Vomiting, fever, then diarrhoea

24
Q

Outline the pathophysiology of rotavirus

A

Cl secretion: Na then follows into lumen then water

SGLT1 disruption: less Na/glucose into enterocyte, so higher osmotic load in gut so water enters

Brush border dysfunction: causes malabsorption

25
Q

What is the transmission method of nororvirus and where in the body does it infect?

A

Faecal-oral, person to person

Infects the small intestine and damages microvilli

26
Q

What are the symptoms and treatment of norovirus?

A

Vomiting, diarrhoea

Fluid rehydration

27
Q

What is the transmission of cryptosporidium?

A

Faecal-oral from contaminated water (commonly affects swimmers)

28
Q

Outline the pathophysiology of cryptosporidium

A

Ingestion of an oocyst which causes watery diarrhoea

29
Q

What is the treatment for cryptosporidium?

A

Fluid rehydration

30
Q

What is the transmission for giardia?

A

Faecal-oral from contaminated water

31
Q

Outline the pathophysiology of giardia

A

Cyst is ingested, stomach acid releases parasite from the cyst which can then damage small intestine and cause villous atrophy. Parasite can then become cyst again and repeat cycle

32
Q

What is the treatment for giardia?

A

Antibiotics and fluid rehydration

33
Q

What is a common condition which can occur following giardia treatment?

A

Lactose intolerance from lactase deficiency

34
Q

What is the transmission for entamoeba histolytica and which people does it commonly affect?

A

Faecal-oral from contaminated water

Affects people in regions with poor sanitation, and MSM

35
Q

Outline the pathophysiology of entamoeba

A

Ingestion of cysts which form trophozoites that invade mucosa (can spread to invade liver).
Cysts then pass out with faeces

36
Q

What is the treatment of entamoeba?

A

Metronidazole

37
Q

Which microorganisms can cause bloody diarrhoea?

A

Shigella (main)

Also campylobacter and entamoeba